Bartonella Henselae

The patient responded well to IV fluid support, plasma expander therapy and endovenous antibiotics. Out-patient therapy included multimodal antibiotics and nutritional support. A single dose of dexamethazone was also administered to reduce inflammation. The patient was essentially asymptomatic for 5 weeks and antibiotic therapy was stopped. One week later the patient again presented for lethargy and anorexia. A follow-up sonogram was performed with power flow Doppler 6 weeks post therapy. Image 3: The residual mass is continuous with the right limb which is mildly enlarged, hypoechoic, with evidence of normal perfusion noted with power flow Doppler. A concurrent splenic abscess was found on sonogram that most likely contributed to the symptoms. Tom was again hospitalized and discharged 3 days later responding to multimodal antibiotic therapy. Surgical biopsies were taken 2 months later by owner request to further define the persistent pathology. The patient was essentially stable at that time. At this time the owners wished to further define this pathology with surgical histopathology: Pancreatic nodular hyperplasia, severe chronic lymphoplasmacytic cholangiohepatitis, Mild, chronic, lymphoplasmacytic enteritis, moderate, chronic, fibrosing inflammation and splenic adhesion. Mild chronic, proliferative, mesenteric lymphadenopathy. Mild, chronic, ulcerative, fibrosing cystitis. This is typical hisopathology of a "triad" cat. The pancreatic nodular hyperplasia would be consistent with sequelae from chronic pancreatitis. The patient recovered uneventfully and was stable without medication 2 months post exploratory surgery. Referring Practitioner: Dawn Garro DVM, Pequannock Animal Hospital, Pompton Plains, NJ, USA